Bethany R Green, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1016 Mississippi Ave Unit 102
Lakeland, FL 33803-1378

Phone

(863) 838-5097

NPI assigned

May 10, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1417531997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 MISSISSIPPI AVE UNIT 102",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031378",
            "telephone_number": "863-838-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 MISSISSIPPI AVE UNIT 102",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031378",
            "telephone_number": "863-838-5097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Spirit Lake Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338805081",
            "country_code": "US",
            "telephone_number": "863-800-0758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BETHANY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Evadney Grant, APRN
• Crystin Grants, LMFT
• Grateful Hands Services, Inc.
• Greater Good Life Services LLC
• Albert Harris Green, ATC, EMT
• Bryce Allen Green, DO
• Chase Frederick Green, DO
• Dominique V Green
• Karen Shepherd Green
• Suprina Michelle Green

• Clinical Social Worker in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.